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A Clinical Study to Enable Process Validation of Commercial Grade OTL-101

Primary Purpose

Severe Combined Immunodeficiency Due to ADA Deficiency

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
OTL-101
Sponsored by
University of California, Los Angeles
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Severe Combined Immunodeficiency Due to ADA Deficiency

Eligibility Criteria

30 Days - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Provision of written informed consent by the subject or parent(s)/legal guardian(s), prior to any study related procedures taking place. Where consent is provided by the parent(s)/legal guardian(s), assent by the subject should also be sought, if appropriate
  • Age ≥30 days and <18 years
  • Diagnosis of ADA-SCID based on either:

    • 1) Evidence of ADA deficiency, defined as Decreased ADA enzymatic activity in erythrocytes, leukocytes, skin fibroblasts, or in cultured fetal cells to levels consistent with ADA-SCID as determined by the reference laboratory OR Identified mutations in ADA alleles consistent with a severe reduction in ADA activity
    • 2) Evidence of ADA-SCID, defined as Family history of a first order relative with ADA deficiency and clinical and laboratory evidence of severe immunologic deficiency OR Evidence of severe immunologic deficiency in subjects prior to the institution of immune restorative therapy, based on at least one of the following:

      • Lymphopenia (absolute lymphocyte count <400 cells/μL) OR absence or low number of T cells (absolute CD3+ count < 300 cells/μL)
      • Severely decreased T lymphocyte blastogenic responses to phytohemagglutinin (either <10% of lower limit of normal controls for the diagnostic laboratory, or <10% of the response of the normal control of the day, or stimulation index <10)
      • Identification of SCID by neonatal screening revealing low T cell receptor excision circles (TREC) levels
  • Ineligible for allogeneic bone marrow transplantation from an Human leukocyte antigen (HLA)-identical sibling donor, with normal immune function
  • For females of child-bearing potential, negative pregnancy test up to 30 days prior to the Screening visit. For all subjects in the reproductive age range, agreement to use highly effective and adequate method of contraception while receiving treatment and for at least 12 months following drug administration
  • Willingness and ability of the subjects and parent(s)/legal guardian(s) to comply with study procedures and requirements, including remaining at the clinic for the required duration of conditioning and treatment and compliance with follow-up evaluations

Exclusion Criteria:

  • Ineligible for autologous HSCT as per clinical site criteria.
  • Hematologic abnormality, defined as:

    • Anemia (Hb <8.0 g/dL)
    • Neutropenia (absolute neutrophil count (ANC) <500 cells/mm3). Note: ANC <500 cells/mm3 with absence of myelodysplastic syndrome on bone marrow aspirate and biopsy and normal marrow cytogenetics are acceptable for eligibility
    • Thrombocytopenia (platelet count <50,000 platelets/mm3)
    • Prothrombin Time (PT) or International Normalized Ratio (INR) and Partial thromboplastin time (PTT) >2 times the upper limit of normal (ULN) (subjects with a correctable deficiency controlled on medication will not be excluded)
    • Cytogenetic abnormalities on peripheral blood or bone marrow or amniotic fluid (if available)
    • Prior allogeneic HSCT with cytoreductive conditioning
  • Pulmonary abnormality, defined as:

    • Resting oxygen (O2) saturation by pulse oximetry <90% on room air
    • Chest X-ray indicating active or progressive pulmonary disease. Note: Chest X- ray indicating residual signs of treated pneumonitis is acceptable for eligibility
  • Cardiac abnormality, defined as:

    • Abnormal electrocardiogram indicating cardiac pathology
    • Uncorrected congenital cardiac malformation with clinical symptoms
    • Active cardiac disease, including clinical evidence of congestive heart failure, cyanosis, hypotension
    • Poor cardiac function as evidenced by left ventricular ejection fraction <40% on echocardiogram
  • Neurologic abnormality, defined as:

    • Significant neurologic abnormality revealed by examination
    • Uncontrolled seizure disorder
  • Renal abnormality, defined as:

    • Renal insufficiency: serum creatinine ≥1.2 mg/dL (106 μmol/L), or ≥3+ proteinuria
    • Abnormal serum sodium, potassium, calcium, magnesium or phosphate levels at >2 times the ULN
  • Hepatic/gastrointestinal abnormality, defined as:

    • Serum transaminases >5 times the ULN
    • Serum bilirubin >2 times the ULN
    • Serum glucose >1.5 times the ULN
  • Oncologic disease, defined as:

    • Evidence of active malignant disease other than Dermatofibrosarcoma protuberans (DFSP)
    • Evidence of DFSP expected to require anti-neoplastic therapy within the 5 years following the infusion of genetically corrected cells (if anti-neoplastic therapy has been completed, a subject with a history of DFSP can be included)
    • Evidence of DFSP expected to be life limiting within the 5 years following the infusion of genetically corrected cells
  • Known sensitivity to busulfan
  • Confirmation of infectious disease at time of Screening assessment for:

    • Human Immunodeficiency Virus (HIV)-1 and HIV-2
    • Hepatitis B and Hepatitis C
    • Parvovirus B19
    • Human T-cell lymphotropic virus (HTLV)-1 and HTLV-2
  • Pregnant at the time of Screening
  • Affected by a major congenital anomaly
  • Likely to require treatment during the study with drugs that are not permitted by the study protocol
  • Previously treated with another form of gene therapy
  • Affected by any other condition(s) which, in the opinion of the Principal Investigator, contraindicate bone marrow harvest, the administration of busulfan and the infusion of OTL-101, or which indicate an inability of the subject or subject's parent(s)/legal guardian(s) to comply with the protocol

Sites / Locations

  • University of California, Los Angeles

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Gene Therapy

Arm Description

Infusion OTL-101

Outcomes

Primary Outcome Measures

Adenosine Deaminase (ADA) enzyme activity
ADA enzyme activity in red blood cells
T cell (CD3+) count
Absolute count of CD3+ cells
Vector Copy Number (VCN)
VCN in granulocytes

Secondary Outcome Measures

Overall Survival (OS)
OS will be defined as the proportion of subjects alive at 12 months post-treatment with OTL-101
Event-free Survival (EvFS)
EvFS will be defined as the proportion of subjects alive with no "event", an event being the resumption of Pegylated adenosine deaminase (PEG-ADA) Enzyme Replacement Therapy (ERT) or the need for a rescue allogeneic hematopoietic stem cell transplant (HSCT) at 12 months post-treatment with OTL-101

Full Information

First Posted
October 24, 2019
Last Updated
August 1, 2022
Sponsor
University of California, Los Angeles
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1. Study Identification

Unique Protocol Identification Number
NCT04140539
Brief Title
A Clinical Study to Enable Process Validation of Commercial Grade OTL-101
Official Title
A Single Arm, Open Label Clinical Study to Enable Process Validation of Commercial Grade Ex Vivo Hematopoietic Stem Cell Gene Therapy (OTL-101) in Subjects With Severe Combined Immunodeficiency Due to Adenosine Deaminase Deficiency (ADA-SCID)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Withdrawn
Why Stopped
Recruitment on hold for business reasons. Study will not be performed.
Study Start Date
October 15, 2019 (Actual)
Primary Completion Date
August 30, 2021 (Actual)
Study Completion Date
August 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of California, Los Angeles

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the current study is to treat at least 3 ADA-SCID patients with OTL-101 prepared by the commercial manufacturing process.
Detailed Description
The safety and efficacy of OTL-101 for the treatment of patients with ADA- SCID have been established in previous clinical trials. The purpose of the current study is to treat at least 3 ADA-SCID patients with OTL-101 prepared by the commercial manufacturing process in order to facilitate collection of data necessary for final manufacturing. Assessments will focus on monitoring safety and engraftment, through the evaluation of parameters describing immunological recovery, ADA enzyme activity and persistence of gene marking (VCN) at 6 months and 12 months. After completion of 12 months of follow-up on the current study protocol, subjects will be enrolled in an observational long-term follow-up study, in order to monitor the long-term safety of treatment with OTL-101.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Severe Combined Immunodeficiency Due to ADA Deficiency

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gene Therapy
Arm Type
Experimental
Arm Description
Infusion OTL-101
Intervention Type
Biological
Intervention Name(s)
OTL-101
Intervention Description
Autologous CD34+ cell enriched population that contains hematopoietic stem and progenitor cells (HSPCs) transduced ex vivo using a lentiviral vector (LV) encoding the human adenosine deaminase (ADA) gene.
Primary Outcome Measure Information:
Title
Adenosine Deaminase (ADA) enzyme activity
Description
ADA enzyme activity in red blood cells
Time Frame
6 months post treatment
Title
T cell (CD3+) count
Description
Absolute count of CD3+ cells
Time Frame
6 months post treatment
Title
Vector Copy Number (VCN)
Description
VCN in granulocytes
Time Frame
6 months post treatment
Secondary Outcome Measure Information:
Title
Overall Survival (OS)
Description
OS will be defined as the proportion of subjects alive at 12 months post-treatment with OTL-101
Time Frame
12 months post treatment
Title
Event-free Survival (EvFS)
Description
EvFS will be defined as the proportion of subjects alive with no "event", an event being the resumption of Pegylated adenosine deaminase (PEG-ADA) Enzyme Replacement Therapy (ERT) or the need for a rescue allogeneic hematopoietic stem cell transplant (HSCT) at 12 months post-treatment with OTL-101
Time Frame
12 months post treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Days
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provision of written informed consent by the subject or parent(s)/legal guardian(s), prior to any study related procedures taking place. Where consent is provided by the parent(s)/legal guardian(s), assent by the subject should also be sought, if appropriate Age ≥30 days and <18 years Diagnosis of ADA-SCID based on either: 1) Evidence of ADA deficiency, defined as Decreased ADA enzymatic activity in erythrocytes, leukocytes, skin fibroblasts, or in cultured fetal cells to levels consistent with ADA-SCID as determined by the reference laboratory OR Identified mutations in ADA alleles consistent with a severe reduction in ADA activity 2) Evidence of ADA-SCID, defined as Family history of a first order relative with ADA deficiency and clinical and laboratory evidence of severe immunologic deficiency OR Evidence of severe immunologic deficiency in subjects prior to the institution of immune restorative therapy, based on at least one of the following: Lymphopenia (absolute lymphocyte count <400 cells/μL) OR absence or low number of T cells (absolute CD3+ count < 300 cells/μL) Severely decreased T lymphocyte blastogenic responses to phytohemagglutinin (either <10% of lower limit of normal controls for the diagnostic laboratory, or <10% of the response of the normal control of the day, or stimulation index <10) Identification of SCID by neonatal screening revealing low T cell receptor excision circles (TREC) levels Ineligible for allogeneic bone marrow transplantation from an Human leukocyte antigen (HLA)-identical sibling donor, with normal immune function For females of child-bearing potential, negative pregnancy test up to 30 days prior to the Screening visit. For all subjects in the reproductive age range, agreement to use highly effective and adequate method of contraception while receiving treatment and for at least 12 months following drug administration Willingness and ability of the subjects and parent(s)/legal guardian(s) to comply with study procedures and requirements, including remaining at the clinic for the required duration of conditioning and treatment and compliance with follow-up evaluations Exclusion Criteria: Ineligible for autologous HSCT as per clinical site criteria. Hematologic abnormality, defined as: Anemia (Hb <8.0 g/dL) Neutropenia (absolute neutrophil count (ANC) <500 cells/mm3). Note: ANC <500 cells/mm3 with absence of myelodysplastic syndrome on bone marrow aspirate and biopsy and normal marrow cytogenetics are acceptable for eligibility Thrombocytopenia (platelet count <50,000 platelets/mm3) Prothrombin Time (PT) or International Normalized Ratio (INR) and Partial thromboplastin time (PTT) >2 times the upper limit of normal (ULN) (subjects with a correctable deficiency controlled on medication will not be excluded) Cytogenetic abnormalities on peripheral blood or bone marrow or amniotic fluid (if available) Prior allogeneic HSCT with cytoreductive conditioning Pulmonary abnormality, defined as: Resting oxygen (O2) saturation by pulse oximetry <90% on room air Chest X-ray indicating active or progressive pulmonary disease. Note: Chest X- ray indicating residual signs of treated pneumonitis is acceptable for eligibility Cardiac abnormality, defined as: Abnormal electrocardiogram indicating cardiac pathology Uncorrected congenital cardiac malformation with clinical symptoms Active cardiac disease, including clinical evidence of congestive heart failure, cyanosis, hypotension Poor cardiac function as evidenced by left ventricular ejection fraction <40% on echocardiogram Neurologic abnormality, defined as: Significant neurologic abnormality revealed by examination Uncontrolled seizure disorder Renal abnormality, defined as: Renal insufficiency: serum creatinine ≥1.2 mg/dL (106 μmol/L), or ≥3+ proteinuria Abnormal serum sodium, potassium, calcium, magnesium or phosphate levels at >2 times the ULN Hepatic/gastrointestinal abnormality, defined as: Serum transaminases >5 times the ULN Serum bilirubin >2 times the ULN Serum glucose >1.5 times the ULN Oncologic disease, defined as: Evidence of active malignant disease other than Dermatofibrosarcoma protuberans (DFSP) Evidence of DFSP expected to require anti-neoplastic therapy within the 5 years following the infusion of genetically corrected cells (if anti-neoplastic therapy has been completed, a subject with a history of DFSP can be included) Evidence of DFSP expected to be life limiting within the 5 years following the infusion of genetically corrected cells Known sensitivity to busulfan Confirmation of infectious disease at time of Screening assessment for: Human Immunodeficiency Virus (HIV)-1 and HIV-2 Hepatitis B and Hepatitis C Parvovirus B19 Human T-cell lymphotropic virus (HTLV)-1 and HTLV-2 Pregnant at the time of Screening Affected by a major congenital anomaly Likely to require treatment during the study with drugs that are not permitted by the study protocol Previously treated with another form of gene therapy Affected by any other condition(s) which, in the opinion of the Principal Investigator, contraindicate bone marrow harvest, the administration of busulfan and the infusion of OTL-101, or which indicate an inability of the subject or subject's parent(s)/legal guardian(s) to comply with the protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Orchard Therapeutics Clinical Trials
Organizational Affiliation
Orchard Therapeutics (Europe) Limited
Official's Role
Study Director
Facility Information:
Facility Name
University of California, Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Clinical Study to Enable Process Validation of Commercial Grade OTL-101

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